Worst Pills, Best Pills

An expert, independent second opinion on more than 1,800 prescription drugs, over-the-counter medications, and supplements

CDC Seeks to Rein In Overprescribing of Opioids for Chronic Pain

Worst Pills, Best Pills Newsletter article March, 2016

The Centers for Disease Control and Prevention (CDC), perhaps more than any other agency of the U.S. government, understands the public health crisis caused by drug addiction in the U.S. — an epidemic fueled by overprescribing of opioids. CDC scientists have carefully documented the increasing death toll from the expanding opioid addiction epidemic over the past two decades: Since 1999, more than 140,000 people have died from overdoses related to opioid pain medication in the U.S.[1] More...

The Centers for Disease Control and Prevention (CDC), perhaps more than any other agency of the U.S. government, understands the public health crisis caused by drug addiction in the U.S. — an epidemic fueled by overprescribing of opioids. CDC scientists have carefully documented the increasing death toll from the expanding opioid addiction epidemic over the past two decades: Since 1999, more than 140,000 people have died from overdoses related to opioid pain medication in the U.S.[1] More than 16,000 deaths related to opioid overdoses occurred in 2013, a fourfold increase over the number of such deaths in 1999.[2]

In December 2015, the CDC issued proposed guidelines for prescribing opioids for chronic pain. These guidelines offer commonsense, evidence-based recommendations for primary care providers who prescribe opioids for chronic pain outside of cancer treatment or end-of-life care. Once finalized, the guidelines would substantially advance efforts to reverse the trends in opioid addictions and overdose deaths in the U.S.

In developing the guidelines, the CDC consulted with experts and took steps to insulate the process from the corrupting influence of opioid drug manufacturers and industry-funded patient and physician groups that often promote opioid use.[3] For example, when seeking input from nongovernment experts, the agency excluded anyone who had a financial or promotional relationship with any company that makes a product that might be affected by the guidance. Such actions were essential, given that the overprescribing of opioids has been driven in large part by the aggressive marketing efforts of the opioid industry, efforts that too often have involved illegal promotion.

Critics of the guidelines — including some with financial ties to opioid drugmakers[4] — say the recommendations will restrict primary care providers’ ability to prescribe opioids and prevent patients with chronic pain from receiving necessary treatment. These criticisms are unfounded. The recommendations would be completely voluntary and would not place any enforceable restrictions on health care providers’ opioid prescribing practices. Hopefully, primary care providers who prescribe opioids for chronic pain will abide by the finalized recommendations.

The CDC originally planned to finalize the guidelines in January but delayed doing so because of strident opposition from physician and patient groups aligned with the pharmaceutical industry.[5] At press time, the CDC had not yet finalized the guidelines.

Too many patients have already needlessly died from overdoses or suffered from addiction because of the overprescribing of opioids. Any further delay in finalizing the CDC guidelines would be unacceptable.

References

[1] Centers for Disease Control and Prevention. CDC guideline for prescribing opioids for chronic pain — United States, 2016. http://www.regulations.gov/#!documentDetail;D=CDC-2015-0112-0002. Accessed January 11, 2016.

[2] Ibid.

[3] Ibid.

[4] Perrone M. Bold bid to rein in painkiller prescriptions hits roadblocks. December 19, 2015. Associated Press. http://www.washingtontimes.com/news/2015/dec/19/bold-bid-to-rein-in-painkiller-prescriptions-hits-/?page=all. Accessed January 19, 2016.

[5] Ibid.